Why are some Stage IV lung cancers operable and some are not?

Can anyone help me understand why some Stage IV lung cancer is operable and some are Not? My mom has stage IV NSCLC and has been told surgery isn't an option. I didn't ask why as I feared the answer and didn't want to ask in front of my mom. But I'm reading posts on here where some have Stage IV and did get surgery. She just completed 10 days of radiation and her first round of chemo. After day one of chemo, there was noticeable shrinkage in the lymph nodes in her neck.

Heather Caron
H
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28 ANSWER

There could be different reasons. Such as the location of the tumor itself, the overall health and lung capacity of the patient are also taken into consideration.

Diana Sargent
D

Ok. This makes sense because she was a smoker for 30 years so I'm sure the lungs are very damaged. She did quit 6 years ago.

Heather Caron 3 years

It depends also on what type of cancer she has, they don't usually operate on small cell x

Julie Branch 3 years

She's non small cell. Thanks for the input

Heather Caron 3 years

They told us that it would be considered malpractice to do it with dad. Even though at the time he had one tumor in his left top lobe it had already spread to the brain.

Crystal Garrison
C

My mom's it top right lobe. Spread to lymph nodes. Brain scan is to be completed yet.

Heather Caron 3 years

The fact that it’s in the lymph nodes may be the reason they don’t want to operate. Likely they have recommended chemo and or radiation. When it does shrink there is a possibility they will still do surgery but they need to shrink first and also it depends on how many lymph nodes are involved.

Faye Woody 3 years

Thanks Faye Woody. She did just complete 10 days of radiation and started chemo Tuesday. After just one chemo treatment, there was noticeable shrinkage in the lymph nodes.

Heather Caron 3 years

My mom has 2 tumors each lung. Inoperable also.

Shay Morin
S

How is she?

Heather Caron 3 years

She is doing alright. She started with every 3 week chemo which really kicked her butt but did respond well. They kicked her down to just one of the types of chemo more maintenance style and it grew again so now they have her on every week chemo(two different types).. She has some difficulties but she is staying positive and keeping faith.

Shay Morin 3 years

Attitude is most of the battle!!!!

Heather Caron 3 years

Absolutely!! Sending prayers for you your mom and your family. It’s tough but the battle CAN and won!! Even stage 4!!

Shay Morin 3 years

Sweetie I’m going to send you a private message.

Shay Morin 3 years
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We was told it was in both lungs it inoperable

Robin Padilla
R

They told us with my dad since it had already spread there was no use in surgery because they wouldn't be able to get it all. I do wonder why some do radiation and chemo and others just chemo. My dad only does chemo treatments stage IV but no radiation. Just curious why some do it and others dont.

Sandy Mcconnell
S

I'm curious too. And why some radiation is weeks and others are only a few days. My mom did 10 days of radiation. Again questions I have but do not want to ask in front of her.

Heather Caron 3 years

My radiation was Stereotactic Body Radiation Therapy (SBRT) which is more concentrated so I only had 5 sessions. Lesion was fairly small too though

Jill Massey 3 years

Even my dad, inoperable and chemo only

Aarona Rucker 3 years

Usually stage 4 means there is more than one main tumour and surgery is usually only offered for single tumours as there is no point operating if the cancer has already spread. Another reason, if there is only one large tumour could be location. If it's too close to the heart for instance surgery could be impossible

Mary Vick
M

That makes sense. So then we just hope the radiation and chemo takes care of it?

Heather Caron 3 years

Yep

Mary Vick 3 years

I was told also that if more then one they can’t get it all. I was also told that stage 4 never gets operated on, and I have not seen any stage 4 have surgery. The doc also said it takes considerable time to recover from surgery and the tumors that spread would be growing while your body tries to heal from surgery.

Deb Bruno
D

I have encountered people on this page .... I think at least 2.... Who were stage IV and did have surgery.

Heather Caron 3 years

Heather Caron I am one of those - see comment below

Jill Massey 3 years

Thanks for the input Jill Massey. I thought so

Heather Caron 3 years

I was Stage IV because it was in both lungs, but it had not spread to lymph nodes or elsewhere, so I had two surgeries - lower right lobectomy & upper left wedge resection. The nodule in lower left lobe was centrally located, which meant they would likely have to remove the whole lobe and I could have ended up on oxygen so I opted for radiation (SBRT) instead. I also was in good health & age 48 when diagnosed.

Jill Massey
J

So maybe if there isn't lymph node involved that's the difference?

Heather Caron 3 years

Heather Caron I think yes, and losing that lung tissue/capacity wasn't a big deal for me overall

Jill Massey 3 years

That makes sense

Heather Caron 3 years

Jill Massey were those surgeries at the same time or two different times?

Debbie Hall 3 years

My understanding is that if it is stage 4 it has metastasized so it is in more than one place, spread from the original site and surgery would not get rid of it.

Joanne Jeffers
J

Same here. And it's the surgeons call.

Dale Hamm 3 years

Following. And sending prayers

Kimberly Epps
K

I just went through that with my husband. Small cell is like a dandelion and the seeds blow all over. Surgery was not an option.

Bobbie Michel
B

That's a great way to describe it. I wondered the difference.

Heather Caron 3 years

I have two sisters one diagnosed 6 months ago small cell she had radiation & then chemo she has done really good, the Dr's informed her it will probably pop up somewhere else. My other sister was diagnosed a month ago with non-small contained to both lungs she just started radiation last week once every 3 weeks, both have inoperable lung cancer & both are stage lV.
This group has been a blessing for me, you take the good days and the bad days with Faith, Love & Hope!
Sending thoughts & prayers.

Sherry Dorsey
S

Definitely a roller coaster ride. Prayers to your sisters

Heather Caron 3 years

Prayers for your sisters and you and your family

Stephanie Harden 3 years

Stage 4 with bone mets so surgery is not an option according to my Onco since it's already spread outside the lung area.

Shiela Gould
S

Stage 4 means it has spread to more than one other organ. In my case I am considered inoperable because it’s in both lungs.

Kim Villegas
K

My mom couldn’t due to location. Much too close to her heart and main arteries

Niki Hughes
N

Mine is stage IV and in the pleural lining. I have no one tumor, so therefore inoperable. Best of luck.

Marybeth Mccollum
M

Mine can't either because it is in several places. Small nodes.

Lou Carmichael
L

My mom was sent to talk to a surgeon. At the time, the surgeon and the oncologist he consulted with said there was a possibility the spots on my mom's spine were related to inflammation and not the cancer. Also, they said a wedge biopsy of the tumor in the lung was not possible due to the location. So the only way to get a biopsy was to remove her RLL. I don't know if there was a better option. We were only now, 3 months later, were able to get a second opinion. My mom would have chosen to NOT have the surgery if that was an option. She has lingering pain that her pain management doctor says will be long lasting. But at the time she was told she could have the surgery now or wait 3 months and potentially have it then.

Kelli Williams
K

I had an octopus of arms off my main tumor which was wrapped around my aorta and bronchus. No way to get to it without bleeding out.

Annie Spears
A

stage iv just means that cancer started somewhere then metastasized and spread. Depends where it is, with me my lung cancer was too widespread to make surgery or radiation an option, also because it was in the lymph nodes. So if they removed the entire lung, it could still be in the nodes. They don't want to do surgery unless they're pretty sure they're getting it all.

Mike Reed
M

So then you just rely on chemo and radiation to do the trick?

Heather Caron 3 years

I am stage 4 because I have it in both lungs. Others I think have tumors wrapped around very vital parts where surgery is just not an option.

Kim Villegas
K

Reasons vary all over the place. For me personally, the cancer has spread to several lipid glands and with surgery they didn't feel they would get everything. Therefore, I just finished chemo and radiation. On February 12th I find out if everything got caught and what is next. Next could be surgery and I just have to sweat it out until I get the news.

Jacqueline Malone
J

Good luck to you!!!

Heather Caron 3 years

Heather Caron, thanks!

Jacqueline Malone 3 years

If I’m not mistaken, to be stage IV, there would have to be metastasis to another part of the body. So if the tumor is contained to the lung, surgery could potentially remove all cancer but once it has spread, surgery is pointless bc the cancer is in other places so you try chemo to shrink or eradicate them all.

Aimee Caldwell
A

I am also not a surgical candidate, i was never given a why. We guessed that it had already reached my lymph nodes....
but I am also almost on the 3rd year of stable/remission...

Sabrina Early
S

That's great sabrina!!!! What treatments were you doing

Heather Caron 3 years

I sympathize with your position; I am in the same position with my husband. He finally opted for surgery on the tumor on his spine, though surgery on the mass in his lung was never suggested. I am so glad he opted (finally) to do the surgery on the spine--after surgery and rounds of immunotherapy, he is 10 months in and in remission. If I may offer one piece of advice--DO NOT be afraid to ask questions in front of your mom. What I learned with my husband is that I am often able to voice what he is thinking but hasn't thought of or doesn't want to rock that boat--Go ahead and ask the questions--the answers are ammunition for you and your mom to deal with all of this.

Kathy Askew
K

I don't believe they will do surgery when diagnosed as stage 4. Some have surgery at an earlier stage and then later it becomes stage 4

Ally Dowdy
A

I have breast cancer that spread to my lung, pelvis, spine, and lymphnodes and my Dr said because it's in so many places they can't operate I my lung either.. My tumor is over 5 cm

Barbie Talbot
B

Once you reach stage IV the C has usually metastasized and is in other organs and systems. So operating on the lung is really not going to do much in the way of a treatment. I am very sorry that your mother is sick, and I hope they have a good treatment plan for her. You will all have my thoughts and prayers.

James Staton
J